U.S. patent number 4,750,475 [Application Number 06/892,832] was granted by the patent office on 1988-06-14 for operating instrument guide mechanism for endoscope apparatus.
This patent grant is currently assigned to Kabushiki Kaisha Machida Seisakusho. Invention is credited to Tokusaburo Yoshihashi.
United States Patent |
4,750,475 |
Yoshihashi |
June 14, 1988 |
Operating instrument guide mechanism for endoscope apparatus
Abstract
An endoscope apparatus comprises an endoscope and an elongated
operating instrument adapted to be inserted into the endoscope. The
endoscope includes an inserting portion extending from an operating
body and adapted to be inserted into a body cavity. A guide tube is
provided on the operating body so as to communicate with a guide
channel formed through the operating body and the inserting
portion. The operating instrument is inserted from the guide tube
into the guide channel while being guided by the guide tube, so
that a distal end of the operating instrument projects from the
guide channel into the body cavity. The guide tube has a bent
configuration and is supported on the operating body for turning
movement relative thereto.
Inventors: |
Yoshihashi; Tokusaburo
(Ichikawa, JP) |
Assignee: |
Kabushiki Kaisha Machida
Seisakusho (Tokyo, JP)
|
Family
ID: |
14875502 |
Appl.
No.: |
06/892,832 |
Filed: |
August 1, 1986 |
Foreign Application Priority Data
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Aug 14, 1985 [JP] |
|
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60-124039[U] |
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Current U.S.
Class: |
600/153;
600/131 |
Current CPC
Class: |
A61B
10/04 (20130101); A61B 1/0052 (20130101) |
Current International
Class: |
A61B
1/005 (20060101); A61B 10/00 (20060101); A61B
001/00 () |
Field of
Search: |
;128/3,4,5,6,7 |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
Primary Examiner: Grieb; William H.
Attorney, Agent or Firm: Kane, Dalsimer, Sullivan, Kurucz,
Levy, Eisele and Richard
Claims
What is claimed is:
1. An endoscope apparatus comprising:
an endoscope including an operating body, an inserting portion
extending from said operating body and adapted to be inserted into
a body cavity, and at least one guide channel extending through
said operating body and said inserting portion;
an elongated operating instrument adapted to be inserted into said
guide channel so as to have a distal end projecting from said guide
channel into the body cavity; and
guide means for guiding the insertion of said operating instrument
into said guide channel, said guide means comprising at least one
guide tube mounted on said operating body so as to communicate with
said guide channel, said guide tube having a bent configuration in
which said guide tube is composed to a first end portion having a
first axis and a second end portion connected to said first end
portion and having a second axis extending at an angle to the first
axis of said first end portion, said first end portion being
supported on said operating body for turning movement relative to
thereto about the first axis of said first end portion.
2. An endoscope apparatus as defined in claim 1, wherein said guide
tube is located at an end of said operating body opposite to an end
thereof from which said inserting potion extends.
3. An endoscope apparatus as defined in claim 1, wherein said guide
tube is located adjacent an end of said operating body from which
end said inserting portion extends.
4. An endoscope apparatus as defined in claim 1, wherein said
operating body is generally in the form of a gun having a grip and
a support section connected thereto so as to project therefrom,
said grip having a longitudinal axis extending at an angle with
respect to a longitudinal axis of said inserting portion, said
inserting portion extending from an end of said support section
remote from said grip.
5. An endoscope apparatus as defined in claim 4, wherein said guide
tube is located at an end of said support section opposite to said
end thereof from which said inserting portion extends.
6. An endoscope apparatus as defined in claim 4, wherein said guide
tube is located adjacent said end of said support section from
which end said inserting portion extends.
7. An endoscope apparatus as defined in claim 1, wherein said
operating body has a grip and an ocular portion in coaxial relation
to said inserting portion, said inserting portion extending from an
end of said grip remote from said ocular portion, said guide tube
being located adjacent an end of said grip opposite to said end
thereof from which said inserting portion extends.
8. An endoscope apparatus as defined in claim 1, wherein said guide
means includes means for preventing said guide tube from being
unintentionally turned relative to said operating body.
9. An endoscope apparatus comprising:
an endoscope including an operating body, an inserting portion
extending from said operating body and adapted to be inserted into
a body cavity, and at least one guide channel extending through
said operating body and said inserting portion;
an elongated operating instrument adapted to be inserted into said
guide channel so as to have a distal end projecting from said guide
channel into the body cavity; and
guide means for guiding the insertion of said operating instrument
into said guide channel, said guide means comprising at least one
guide tube mounted on said operating body so as to communicate with
said guide channel, said guide tube having a bent configuration and
being supported on said operating body for turning movement
relative thereto, said guide means further including means for
preventing said guide tube from being unintentionally turned
relative to said operating body;
said preventing means comprising a support ring fixedly mounted on
said operating body, said guide tube extending through said support
ring for turning movement relative thereto, a plurality of teeth
provided on said support ring, a plurality of teeth provided on
said guide tube and in mesh with said teeth on said support ring,
and resilient means associated with said guide tube for resiliently
biasing the same toward said support ring to bring teeth on said
guide tube into engagement with said teeth on said support ring.
Description
BACKGROUND OF THE INVENTION
The present invention relates to an endoscope apparatus and,more
particularly, to a guide mechanism for guiding an operating
instrument into an endoscope to perform an operation such as, for
example, a collection of a tissue from a body cavity of a
subject.
In a conventionally general endoscope apparatus as disclosed in
Japanese Utility Model Publication No. 58-20245, which can perform
an operation such as a collection of a tissue from a body cavity, a
flexible inserting portion extends from one end of an operating
body, and an ocular portion is provided at the other end of the
operating body. A straight guide tube is fixedly mounted on an
upper portion of the operating body so as to project therefrom
upwardly. A guide channel communicating with the guide tube is
formed through the operating body and the inserting portion.
With the endoscope apparatus constructed as described above, the
inserting portion is inserted into the body cavity, and an interior
of the body cavity is viewed at the ocular portion through an
objective optical system provided at a distal end of the inserting
portion. When a morbid part is found, a tissue is collected, for
example. Specifically, an elongated operating instrument having at
a distal end thereof a pair of forceps is inserted from the guide
tube into the guide channel so as to have the forceps projecting
from the guide channel. The forceps are remotely controlled by an
operation of an operating mechanism provided at a proximal end of
the operating instrument, to allow the forceps to bite off a tissue
from the morbid part.
In the above-described endoscope apparatus, it is often necessary
or desirable to turn the operating body to turn the inserting
portion around its longitudinal axis, to thereby alter the
orientation of the inserting portion within the body cavity. The
turning movement of the operating body remarkably affects the
insertion and operation of the operating instrument. More
particularly, when an operating surgeon holds the operating body in
his natural attitude, the guide tube is oriented upwardly and,
accordingly, it is easy for the operating surgeon to perform the
insertion of the operating instrument into the guide tube and the
operation of the operating instrument. However, when the operating
body is turned to turn the inserting portion around its
longitudinal axis, the position and orientation of the guide tube
vary. Therefore, an unnatural attitude would sometimes be forced on
the operating surgeon when he inserts the operating instrument into
the guide tube or when he operates the operating instrument. This
would render the operation by the operating surgeon
troublesome.
OBJECT AND SUMMARY OF THE INVENTION
An object of the present invention is to provide an endoscope
apparatus which facilitates an insertion and operation of an
operating instrument even when an operating body is turned.
According to the present invention, there is provided an endoscope
apparatus comprising:
an endoscope including an operating body, an inserting portion
extending from the operating body and adapted to be inserted into a
body cavity, and at least one guide channel extending through the
operating body and the inserting portion;
an elongated operating instrument adapted to be inserted into the
guide channel so as to have a distal end projecting from the guide
channel into the body cavity; and
guide means for guiding insertion of the operating instrument into
the guide channel, the guide means comprising at least one guide
tube mounted on the operating body so as to communicate with the
guide channel, the guide tube having a bent configuration and being
supported on the operating body for turning movement relative
thereto.
BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a schematic view showing an endoscope apparatus
comprising an endoscope and accessories therefore, in accordance
with an embodiment of the invention;
FIG. 2 is a side elevational view showing the endoscope shown in
FIG. 1 held with an operating surgeon's left hand;
FIG. 3 is an enlarged fragmental, partially cross-sectional view
showing an operating instrument guide mechanism incorporated in the
endoscope shown in FIGS. 1 and 2:
FIGS. 4, 5 and 6 are end views respectively illustrating turning
adjustments of a guide tube shown in FIG. 3 in accordance with
different turned conditions of an inserting portion;
FIG. 7 is a fragmental side elevational view of an endoscope
apparatus in accordance with another embodiment of the invention;
and
FIG. 8 is a fragmental side elevational view showing an endoscope
apparatus in accordance with still another embodiment of the
invention.
DETAILED DESCRIPTION
The invention will now be described in detail, by way of example,
with reference to the drawings.
FIGS. 1 through 6 illustrate an endoscope apparatus in accordance
with an embodiment of the invention. As shown in FIG. 2, the
endoscope apparatus comprises an endoscope 1 and an elongated
operating instrument 50 which is, in use, inserted into the
endoscope 1. An overaall construction of the endoscope 1 will first
be outlined with reference to FIGS. 1 and 2. The endoscope 1
includes an operating body 10 which is generally in the form of a
gun comprised of a grip 11 and a support section 12 extending
forwardly from an upper end of the grip 11. An inserting portion 20
extends from an end of the support section 12 remote from the grip
11. The inserting portion 20 is flexible and has a bendable section
21 at a distal end of the inserting portion 20 and a hard or rigid
tip component 22 at a distal end of the bendable section 21. The
grip 11 has its longitudinal axis which intersects a longitudinal
axis of the inserting portion 20 and which is inclined downwardly
and away from the distal end of the inserting portion 20.
The grip 11 has mounted thereon two operating dials 14 and 15
which, as shown in FIG. 4, are supported on a hub 16 formed on an
upper side surface of the grip 11, in coaxial relation to each
other, in such a manner that the operating dials 14 and 15 can be
turned around an axis of the hub 16. The operating dials 14 and 15
are connected to the bendable section 21 through respective force
transmission mechanisms each including a pair of operating wires,
to operate the bendable section 21 so as to variably curve the
same.
As shown in FIG. 1, the tip component 22 has an end face 22a
provided therein with a viewing window 23 and an illuminating
window 24. The tip component 22 has disposed therewithin a solid
state image pickup element or image sensor 25 which is optically
connected to the viewing window 23 through an objective optical
system 26 and to which a signal line 27 is connected. The
illuminating window 24 is optically connected to an end face of an
optical fiber bundle 28.
A cable 30 has on end thereof connected to a lower end of the grip
11 and the other end connected to a processor unit 31 which has
incorporated therein a scanning control circuit and a light source.
The scanning control circuit is electrically connected to the image
sensor 25 through the aforesaid signal line 27. The light source is
optically connected to the illuminating window 24 through the
aforesaid optical fiber bundle 28. The signal line 27 and the
optical fiber bundle 28 extend to the processor unit 31 through the
inserting portion 20, operating body 10 and cable 30. The processor
unit 31 is connected to an image receiver 32 such as a CRT
display.
An operating instrument guide mechanism 40, by which the present
invention is characterized, for guiding the insertion of the
operating instrument 50 into the endoscope 1 to be described later,
is provided on an end of the operating body 10 opposite to an end
thereof from which the inserting portion 20 extends. As shown in
detail in FIG. 3, the guide mechanism 40 comprises a guide tube 41
which is supported on the operating body 10 by means of a support
ring 42 for turning movement relative thereto. Specifically, the
operating body 10 has formed therein an inserting bore 10a through
which the support ring 42 is inserted. A flange 42a extending
outwardly from an outer periphery of the support ring 42 abuts
against an outer surface of the operating body 10 and is fastened
thereto by means of screws 43, so that the support ring 42 is
fixedly mounted on the operating body 10. The guide tube 41 has a
base end thereof inserted into the support ring 42 for turning
movement relative thereto. An annular seal member 44 is interposed
between the guide tube 41 and the support ring 42 to provide a
fluid tightness therebetween.
A cup-shaped cover 45 is threadedly engaged with the outer
periphery of the support ring 42. The cover 45 has a bottom wall
having formed therethrough an inserting bore 45a through which the
guide tube 41 extends. A coil spring 46 is interposed between the
bottom wall of the cover 45 and a flange 41a extending outwardly
from an outer periphery of the guide tube 41, to resiliently urge
the flange 41a against an end face of the support ring 42, to
thereby prevent the guide tube 41 from comming out of the support
ring 42.
The flange 41a of the guide tube 41 has an end face having formed
thereon a daisy seat 41b which has an annular configuration in plan
and which has a plurality of radially extending teeth and grooves
arranged alternately. The daisy seat 41b of the flange 41a is in
mesh with a similar daisy seat 42b on an end face of the support
ring 42 to prevent the guide tube 41 from being angularly moved
relative to the support ring 42 accidentally or
unintentionally.
The guide tube 41 is bent at an intermediate portion 41c thereof,
and has a free end opening 41d closed by a rubber cap 47. The cap
47 is snap-fitted on an annular projection 41e formed on the outer
periphery of the free end of the guide tube 40. The cap 47 has a
central portion 47a which has a relatively thin wall thickness and
which has a cruciform cut 41b formed therein as shown in FIG. 4. An
operating dial 41f is intergrally formed around a portion of the
guide tube 41 which is located between the bent central portion 41c
thereof and the operating body 10.
The support ring 42 has a tubular portion 42c which projects into
the operating body 10 and to which is connected one end of a guide
tube 48 defining a guide channel 49 extending through the operating
body 10 and the inserting portion 20 as shown in FIG. 2. The guide
tube 48 extends through the operating body 10 and the inserting
portion 20 and has the other end connected to an opening (not
shown) formed in the end face 22a of the inserting portion 20.
As shown in FIG. 2,the aforementioned elongated operating
instrument 50 to be inserted into the endoscope 1 comprises a
flexible helical tube 51, a pair of forceps 52 at a distal end of
the helical tube 51 and a operating mechanism 53 at a proximal end
of the helical tube 51. The pair of forceps 52 are generally in the
form of a semi-spherical shell and are adapted to be opened and
closed by a linkage (not shown). The operating mechanism 53
includes a hollow shaft 53a having one end thereof having a ring
53b connected thereto and the other end having the helical tube 51
connected thereto. a slider 53x is slidably mounted on the shaft
53a and has flanges 53c and 53d and a tubular section 53e extending
between the flanges 53c and 53d to connect them to each other. A
wire (not shown) is inserted into the helical tube 51 and has one
end connected to the aforesaid linkage and the other end extending
through the shaft 53a and connected to the slider 53x.
The operation of the endoscope apparatus constructed as described
above will now be described. An operating surgeon holds the grip 11
of the endoscope 1 with his left hand, and inserts the inserting
portion 20 into a body cavity of a subject, for example, from his
mouth into his stomach. Light from the light source within the
processor unit 31 passes through the optical fiber bundle 28 and is
irradiated from the illuminating window 24 into the body cavity.
Light reflected from an inner wall surface of the body cavity
passes through the viewing window 23 and the objective optical
system 26 and is received by the image sensor 25, so that an image
of the inner wall surface of the body cavity is imaged on a light
receiving surface of the image sensor 25.
The image sensor 25 photoelectrically transduces the image to
generate a picture signal. The scanning control circuit within the
processor unit 31 receives the picture signal from the image sensor
25 and sends the picture signal to the image receiver 32. As a
result, the image of the inner wall surface of the body cavity is
projected on the image receiver 32. The operating surgeon operates
the endoscope 1 while watching the image receiver 32, to view the
interior of the body cavity.
The operating surgeon grasps the grip 11 of the endoscope 1 with a
so-called ordinary grip in a manner similar to that in which one
holds a gun, as shown in FIG. 2. The operating surgeon causes the
grip 11 to abut against the palm of his hand and supports the grip
11 with his ring and little fingers. The turning movement of the
operating dial 14 with the operating surgeon's thumb and middle
finger is transmitted to the bendable section 21 through the
operating wires, to cause the bendable section 21 to be curved in a
direction indicated by the arrows X--X'. In addition, the turning
of the other operating dial 15 with the operating surgeon's thumb
and forefinger causes the bendable section 21 to be curved in a
direction perpendicular to the direction indicated by the arrows
X--X'.
When it is desired to alter the direction or orientation of the
inserting portion 20 within the body cavity, the operating surgeon
twists his forearm, with the grip 11 being grasped in the manner
described above, to turn the inserting portion 20 around its
longitudinal axis.
When a morbid part is found during the viewing or observation, the
operating surgeon holds the operating instrument 50 with his right
hand and inserts the operating instrument 50 through the cut 47b in
the cap 47 of the guide mechanism 40 into the guide tube 41, and
through the guide channel 49 to allow the distal end of the
operating instrument 50 to project into the body cavity from the
end face 22a of the inserting portion 20. Thus, the guide tube 41
serves to guide the insertion of the operating instrument 50 into
the guide channel 49. Then, the operating surgeon moves the forceps
52 to the morbid part. At the operating mechanism 53, the operating
surgeon inserts the thumb of his right hand into the ring 53b and
inserts the forefinger and middle finger into between the flanges
53c and 53d with the tubular section 53e being positioned between
the forefinger and middle finger. Then, the slider 53x is pulled
toward the ring 53b to close the forceps 52 through the wire and
likage, to thereby bite off a tissue of the morbid part.
Subsequently, with the operating mechanism 53 being held with the
operating surgeon's right hand, he pulls the operating instrument
50 out of the endoscope 1.
The turning adjustment of the guide tube 41 of the guide mechanism
40 will now be described. The turning adjustment of the guide tube
41 is performed by the turning of the dial 41f. Upon the turning of
the dial 41f, the guide tube 41 is slightly moved axially against
the biasing force of the coil spring 46 to allow the teeth of the
daisy seat 41b on the guide tube 41 to climb over the teeth of the
daisy seat 42b on the support ring 42.
As shown in FIG. 4, under the condition that the grip 11 is not
turned, the guide tube 41 is directed or oriented rightward
obliquely upwardly. Under this conditions, it is easy for the
operating surgeon to insert the operating instrument 50 into the
guide tube 41 with the instrument 50 being held with his right
hand, and it is also easy for the operating surgeon to operate the
operating mechanism 53 to remotely control the forceps 52.
When the operating body 10 is turned in the clockwise direction
through 90 degrees, if the guide tube 41 is maintained in the
annular relation to the operating body 10 shown in FIG. 4, the
guide tube 41 would be directed rightward obliquely downwardly.
Then, it would be difficult for the operating surgeon to insert and
operate the operating instrument 50, and an unnatural attitude
would be forced on the operating surgeon. In this case, as shown in
FIG. 5, the guide tube 41 ia angularly moved or turned in the
counterclockwise direction relative to the operating body 10 to
direct the guide tube 41 rightward obliquely upwardly, to thereby
facilitate the insertion and operation of the operating instrument
50.
Furthermore, when the operating body 10 is turned in the
counterclockwise direction, as shown in FIG. 6, the guide tube 41
is turned in the clockwise direction relative to the operating body
10, to direct the guide tube 41 rightward obliquely upwardly.
Additionally, if the operating surgeon holds the endoscope 1 and an
assistant operates the operating instrument 50, the guide tube 41
is turned and adjusted so as to facilitate the operation by the
assistant, i.e., such that the guide tube 41 is always directed
leftward obliquely upwardly.
FIG. 7 shows an endoscope apparatus in accordance with another
embodiment of the invention, in which a projection 12a is formed
adjacent the end of the support section 12 from which the inserting
portion 20 extends, and the operating instrument guide mechanism 40
is associated with the projection 12a. The embodiment shown in FIG.
7 is similar in other respects to the embodiment described with
reference to FIGS. 1 through 6. In FIG. 7, like reference numerals
are used to designate like or similar parts and components shown in
FIG. 1, and the description of such similar parts and components
will therefore be omitted to avoid repetition.
FIG. 8 shows an endoscope apparatus in acordance with still another
embodiment of the invention, in which the operating instrument
guide mechanism 40 described with reference to FIGS. 1 through 6 is
applied to an endoscope 100 which is of the type widely used
conventionally. Specifically, the endoscope 100 comprises an
operating body 60 having a grip 61 and an ocular portion 69 in
coaxial relation to the inserting portion 20. The ocular portion 69
is provded at an end of the operating body 60 opposite to an end
thereof from which the inserting portion 20 extends. The ocular
portion 69 has provided therein an ocular optical system which is
optically connected to a viewing window and an objective optical
system similar to those 23 and 26 shown in FIG. 1, through an image
transmission optical system comprised of an optical fiber bundle.
In FIG. 8, like reference numerals are used to designate like or
similar parts and components shown in FIG. 1, and the description
of such like or similar parts and components will therefore be
omitted for simplification.
Although the embodiments of the present invention have been
described as having a single guide tube 41 and a single guide tube
48 or guide channel 49, the present invention should not be limited
to these particular embodiments, but may have a pluraltiy of such
guide tubes and guide channels.
Moreover, the operating instrument 50 guided by the guide mechanism
40 has been described as having the forceps 52, but may have
injection needles or brushes for resecting a tissue of the inner
wall of the body cavity in substitution for the forceps 52.
As described above, with the endoscope apparatus in accordance with
the present invention, when the operating body is turned to turn
the inserting portion around its longitudinal axis, the guide tube
having the curved configuration is turned correspondingly to the
turning direction and angle of the operating body, to adjust the
angle of the guide tube relative to the operating body. Thus, it is
made possible to facilitate the insertion and operation of the
operating instrument.
* * * * *